Gynaecology

Dr Len Kliman is a Melbourne based gynaecologist who offers highly committed, competent and experienced care for all gynaecological matters. He has a long history of providing gynaecological services throughout both the public and private systems in Melbourne and overseas centres in the UK and the USA. Women’s health can be impacted by many gynaecological issues including pelvic pain, menstrual disorders, vulval and vaginal skin conditions and hormonal issues such as perimenopause/menopause. Dr Kliman is dedicated to keeping up-to-date with the ever-changing scientific advances in the field of gynaecology.

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General Services Clinical Services

General Services

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Vulval & Vaginal Skin Disorders

Dr Kliman is a member of the International Society for the Study of Vulval and Vaginal Diseases and the Australian and New Zealand Society for the Study of Vulval and Vaginal Diseases and has a special interest in this important area of women’s health.

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General Gynaecological Check Ups

All women should have regular well-woman check ups. This includes breast examinations, pelvic ultrasounds to check all the pelvic organs, followed by cervical screening tests if due. Assessment of your pelvic floor strength is also an important part of the examination. Any issues can then be discussed in full.

Abnormal Pap Smears/Colposcopy and Biopsy

Dr Kliman is a registered colposcopist with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and has the necessary skills to assess any abnormalities found on cervical screening tests.

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Management of Pelvic Pain

Women with pelvic pain are always given priority with respect to appointments in view of their symptoms. Dr Kliman is especially experienced in the diagnosis and appropriate management of causes of pelvic pain.

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Adenomyosis

Adenomyosis is a common cause of heavy, painful periods and pain with intercourse. A number of effective treatment options are available.

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Endometriosis

This condition affects many women with a diverse possible range of symptoms. These include pelvic pain, pain with periods (dysmenorrhoea), pain with intercourse, bowel and/or bladder symptoms and reduced fertility. This condition needs to be treated and managed appropriately.

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Menstrual Disorders – Heavy and Painful Periods

Although period pain and heavy periods are common symptoms the question of treatment is especially important in women whose symptoms are interfering with their quality of life. Is your pain debilitating and requiring significant pain relief? Is your level of blood loss resulting in iron deficiency and symptoms of fatigue and lethargy? If so, Dr Kliman will discuss numerous management options.

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Menopause and Scientifically Based MHT (HRT)

Dr Kliman has managed menopausal symptoms for over 30 years. It is important to both consider the impact of these symptoms on your quality of life and discuss the pros and cons of MHT using the most up to date and scientifically valid information.

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Polycystic Ovary Syndrome (PCOS)

PCOS is a complex condition which can be difficult to accurately diagnose. It affects 5 – 10% of all women and the diagnostic criteria (Rotterdam Criteria) consists of irregular and infrequent periods, signs of androgenisation (increased male hormone) such as acne and facial hair, and signs of polycystic ovaries on ultrasound. Dr Kliman will discuss the diagnosis and nature of polycystic ovary syndrome using a useful diagram.

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Premenstrual Syndrome (PMS)

Premenstrual syndrome and the more severe form known as premenstrual dysphoria disorder are often under-treated and tolerated by many women. These disorders need aggressive persistent management to improve the quality of life of women affected by these often serious symptoms.

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Contraception

It is always important to avoid an unplanned pregnancy by using appropriate contraception.
Dr Kliman will discuss all options including oral contraceptives (a number of new low-side effect options are now available), barrier methods, IUDs and permanent contraception for couples who have finished their families such as vasectomies and tubal ligation.

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder (PMDD) can be considered a severe form of premenstrual syndrome (PMS). Both PMS and PMDD are characterised by unpleasant physical and psychological symptoms that occur in the second half of a woman’s menstrual cycle, most commonly in the days preceding menstruation.

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Clinical Services

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Investigation of Infertility

It is important to exclude any simply-managed causes of delayed fertility. Dr Kliman is experienced in the assessment of couples facing infertility of more than 12 months duration. In women over 35 years of age this assessment should be started after six months of infertility, as being proactive is essential.

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Assessment of Pelvic Floor Dysfunction and Prolapse

Pelvic floor issues can be associated with significant symptoms. These include uncomfortable pressure symptoms, difficulties with intercourse, bladder or bowel issues including incontinence. Often conservative management with pelvic floor physiotherapy and/or vaginal pessaries may be adequate treatment and control your symptoms. If these options are less than adequate in controlling your symptoms a variety of surgical procedures may be necessary to achieve your desired result.

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Pre-pregnancy Assessment

If you are planning a pregnancy, especially if you have had significant issues in a previous pregnancy or have an underlying medical condition, a pre-pregnancy discussion is often valuable. Dr Kliman can discuss a management plan for your up-coming pregnancy including the safety and alternatives for any medication you may require.

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Recurrent Miscarriage

The formal definition of recurrent miscarriage is three spontaneous miscarriages in a row. This distressing situation will be fully investigated to ensure that couples are not at an increased risk of miscarriage. Dr Kliman will carry out all investigations after only two miscarriages, as he believes in being proactive and alleviating any anxiety.

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Assessment of Fibroids

Fibroids or uterine leiomyomas are the commonest lumps found inside the uterus. They can be totally asymptomatic and found only on examination or ultrasound, or can be responsible for pressure symptoms or heavy uterine bleeding. Symptoms vary depending on their size and location. A number of treatment options are available.

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